Methods and devices for spinal fixation element placement

A method for introducing a spinal fixation element into a patient's spinal column, comprising:

• providing at least two percutaneous access devices, each device having
• a proximal end positioned outside a patient's body,
• a distal end coupled to a spinal anchor,
• a lumen extending between the proximal and distal ends of the percutaneous access device and defining a longitudinal axis, and
• at least one sidewall opening extending from the distal end through at least a portion of the percutaneous access device;
• positioning a spinal fixation element through the at least one sidewall opening and adjacent the proximal end of at least two percutaneous access devices such that the spinal fixation element extends in an orientation substantially transverse to the longitudinal axis of each percutaneous access device;
• and
• advancing the spinal fixation element in a distal direction along the longitudinal axis in the substantially transverse orientation to seat the spinal fixation element in a receiver head of at least two adjacent spinal anchors.